The URL can be used to link to this page

Home My WebLink About03-0865Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTER, S Estate of Dorothy Jane Brown also known as Petitioners , Deceased Social Security No. 175-03-2659 Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut ors I_J Decedent, dated 2/14/72 a. nd 9odicil(s) dated None W. Blaine Brown died prior to Dorothy Jane Brown ~ '--~[;~/~p..,~ 't'~D(~ named in the Last Will of the State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence Jeanne L. Baker child William D. Brown child Richard L. Brown child 20 Koser Lane, Shippensburg, Pa. 30 Sprin~l Drive, Shippensburg, Pa 414 Freedom Drive, Shippensburg, Pa (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 410 Big Spring Road, Newville, Penn Township, Pennsylvania (list street, number and municipality) Decedent, then 87 years of age, died October 8 ,2003 , at Cumberland County, Pennsylvania (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA) All personal property ......................................... $ (if not domiciled in PA) Personal property in Pennsylvania .................... $ (if not domiciled in PA) Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total ..................................................................................................................... $ 9,800.00 9,800.00 Real Estate situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence 20 Koser Lane, Shippensburg, Pa. 17257 30 Spring Drive, Shippensburg, Pa. 17257 414 Freedom Drive, Shippensburg, Pa. 17257 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate acc~ording to law. Sworn to and affirmed and subscribed "~ ~ ~J~ ~t/v ~.~. ~/}. ~'_ before me this c;~..~,.~-'~ day of ~h~ October, 2003 -?L _ DECREE OF REGISTER Estate of Dorothy Jane Brown also known as Deceased Social Security No: 175-03-2659 Date of Death: 10/8/03 AND NOW, October , 2003 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters I~ Testamentary [] of Administration (c.t.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoritate) are hereby granted to Jeanne L. Baker, William D. Brown and Richard L. Brown in the above estate and that the instrument(s), if any, dated February 14, 2003 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................... $ Short Certificate(s) ............... $ Renunciation .......................... $ Affidavit ( ) ....................... $ Extra Pages ( ) .............. $ Codicil ................................. $ JCP Fee ................................. $ Inventory & Tax Forms ............. $ Other ...................................... $ TOTAL ............................. $ Attorney Attorney: H. Anthony Adams I.D. No: 25505 Address: 49 West Orange Street, Suite 3 Shippensburg Pa 17257 Telephone: 717-532-3270 DATE FILED: RW-7A OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that , testat f*~X' of (one of the familiar with the signature of codicil subscribing witnesses to) the will presented herewith and that codicil will is in the handwriting of-J0e--~No._~h'c~ ~ to the best of Sworn to or affirmed and sub- day of For the Register scribed before me this I.x-(~' knowledge and belief. (Addre~ (Name) believes the signature on the (Address) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ocal Registrar Fee for this certificate, $2.00 P 4 5 0 2 5 5 No. ~ Date / BLACK INK H105A43 Rev 2~7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH . C,,m,,erland I w. Pennsboro ,,~ Homemaker ... ~NT'S ~ ~u6 ~,~. C~. ~. Ze C~) i~NT.S 410 Big Spring Road ~TU~ ,~.. Pennsylvania , ,z..~ West Penns~oro ,~ewville, PA 17241 Chester Wise ~OR~ANT'S NAME U~e~eq Richard L. Brown 10/13/03 Mary Bowen ]05 North Seneca Street, Shippensburg,PA 17257 Spring Hill cemetery ~Sh~pe~sb~rg~ .... WILL I, DOROTHY JANE BROWN, of R. D. 3, Shippensburg, Southampton Township, Franklin County, Pennsylvania, being of sound mind, memory and disposition, do !ihereby make, publish and declare this my Last Will and Testament hereby iirevoking and making void all wills by me heretofore made. .. FIRST. I order and direct the payment of ali my just debts and funeral expenses as soon as may be convenient after my decease. SECOND. I give, devise and bequeath all my estate, real, personal and mixed, whatsoever and wheresoever situate, to my beloved husband, W. BLAINE BROWN, absolutely. WILLIAM R. MARK ATTORNEY AT LAW ~ THIRD. In the event that my said husband predeceases me or we die as the result of a common disaster, I then give, devise and bequeath all my estate to 't my children, JEANNE L. BAKER, WILLIAM D. BROWN, and RICHARD L. BROWN, share !!and share alike. i!FOURTH.~ I nominate, constitute and appoint my husband, W. BLAINE BROWN, to be lithe Executor of this my Last Will and Testament; and if he be unable to ful- ~fill the duties of Executor, I then nominate constitute and appoint my ~ichildren, JEANNE L. BAKER, WILLIAM D. BROWN, and RICHARD L. BROWN, as Co- !lExecutors of this my Last Will and Testament. IN WITNESS WHEREOF, I, DOROTHY JANE BROWN, have hereunto set my hand and lseal to this my Last Will and Testament, this /~!~-~:-t day of February, 1972. ~i Signed, sealed, published and declared by DOROTHY JANE BROWN, !ithe Testatrix, as and for her !Last Will and Testament, in the presence'of us who have at her ti request signed our names as i!witnesses hereto in the presence i~of the said Testatrix and of each other. (SEAn) DOROTHY JA~IE BROhr~l WILLIAM R. MARK ATTORNEY AT LAW 1 13 EAST KING STREET SHIPPENSBURG, PENNA. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Dorothy Jane Brown Date of Death: 10/8/03 Will No. 2003-00865 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of/the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ~ i ~ / O Name Address Baker, Jeanne L. 20 Koser Road Shippensburq PA 17257 Brown, Richard L. 414 Freedom Drive Shippensburg PA 17257 Brown, William D. 30 Spring Drive Shippensburq PA 17257 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: 2/19/04 Capacity: Signature Name: H. Anthony Adams Address: 49 W. Oran,qe Street, Suite 3 Shippensburq PA 17257 Telephone(717) 5323270 Personal Representative X Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEP. ARTM ENT'"OF REVENUE BUREAU QF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD OO3679 ADAMS H ANTHONY 49 W ORANGE ST SUITE3 SHIPPENSBURG, PA 17257 fold ESTATE INFORMATION: SSN: 175-03-2659 FILE NUMBER: 2103-0865 DECEDENT NAME: BROWN DOROTHY JANE DATE OF PAYMENT: 03/15/2004 POSTMARK DATE: 03/1 2/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/08/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $588.64 REMARKS: SEAL CHECK# 96 TOTAL AMOUNT PAID: $588.64 INITIALS. JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES /NHERTTANCE TAX DTVTSZDN DEPT. 280601 HARR/SDURG, PA 171Z8-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-16~7 EX AFP ANTHONY ADAMS STE 3 W ORANGE ST SHIPPENSBURG PA 17257 DATE 05-03-Z004 ESTATE OF BROWN DATE OF DEATH 10-08-Z003 FILE NUMBER Z1 03-0865 COUNTY CUMBERLAND ACN 101 Amount: RaeLt*ed DOROTHY J HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BROWN DOROTHY J FILE NO. 21 03-0865 ACN 101 DATE 05-03-2004 TAX RETURN ~/AS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTTCE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~a (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) 3. Closely Held S~ock/Par~narship /n~ares~ (Schedule C) (3) ~. Hor~gagas/No~as Receivable (Schedule D) (~) 5. Cash/Bank Daposi~s/Hisc. Personal Propar~y (Schedule E) ($) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Cos~s/Hisc. Expanses (Schedule H) (9) 10. Dab~s/Hor~gaga Liabil/~ias/Lians (Schedule I) (10) 11. To,al Deductions 12. Ne~ Value of Tax Re~urn · O0 NOTE: To insure proper · O0 cradi~ ~o your account, . O0 subai~ ,~t)~ upper portion · O0 ~ of ~:h~ ~orm wi~:h your 15 rTBZ3.76 *ax O0 ~ . .00 ~ (8),~ 15,823.76 2,7~2.85 (11) 2.7~2 .B; (~;) 15,080.91 13. 1~. NOTE~ Charitable/Governmental Bequests; Non-elec~ad 9113 Trusts (Schedule J) (15) . O0 Na~ Value of Es~a~a Subjac~ ~o Tax (1~) 13,080.91 If an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Aaoun~ of L/ne 1~ a~ Spousal ra~e 16. Amoun~ of Line 1~ ~axabla a~ Lineal/Class A ra~a 17. Aeoun~ of Line lq a~ Sibling ra~a 18. Amoun~ of Line 1~ ~axabla a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYHENT RECEIPT D/SCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 03-12-2004 CD003679 .00 (is) .00 x O0 = .00 (26) .00 x 045= .00 (17) 13,080.91 x 12 = 1,569.70 (18) .00 x 15 = .00 (:].9)= 1,569.70 ANOUNT PAID 588.64 PAYMENT MUST BE MADE BY 07-08-2004~. TOTAL TAX CREDIT BALANCE OF TAX DUEI ZNTEREST AND PEN. TOTAL DUE 588.64 981.06 .00 981.06 ( IF TOTAL DUE TS LESS THAN $1, NO PAYHENT IS REI~UZRED. ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULAT/ON OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADH/N- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 19BI -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coaaonaaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the taafut Class B (collateral) rate on any such future interest. To ~ulfiZ1 the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Rills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, ehich mas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at tho Office of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special Z4-hour ansmaring service for forms ordering: 1-800-362-Z050; services for taxpayers eith special hearing and / or speaking needs: 1-B00-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, ar assessment of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviee Unit, Dept. Z80601, Harrisburg, PA 17128-0601 Phone (7173 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (52) discount of the tax paid is allowed. The 152 tax aane:'ty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the saaa manner and in the the saea time period as you would appeal the tax and interest that has bean assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ahich became delinquent before January 1, 1982 bear interest at the rate of six (62) percent par annum calculated at a daily rate of .000164. All taxes which became deIinquent on and after January 1, 1982 wiIl bear interest at a rate which will vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z004 are: Interest DaiIy Interest Daily Year Rate Factor Year Rate Factor ~ 202 .000548 ~'8- X991 llZ .O00~O1 1983 162 .000438 1992 92 .000247 1984 llZ .000301 1993-1994 72 .000192 1985 132 .000356 1995-1998 92 .000247 1986 IOZ . OOO 274 1999 72 . OOOZ9Z 1987 IOZ .000274 ZOO0 72 .000192 --Interest is calculated es folloas: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rate Factor ~ 92 .000247 2002 62 .000164 2003 52 .000137 2004 41 .OOOllO X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest oust be calculated. REV-1470 EX (6-88) INHERITANCE TAX COMMONVVEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 2806O1 HARRISBURG~ PA 17128-0601 DECEDEN'rS NAME DOROTHY J. BROWN FILE NUMBER REVIEWED BY CHARLES WRIGHT ACN 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES J Siblings are taxable at the rate of 12% for dates of death on or after 07-01-2000. ROW Page 1 REV- 1 SO0 EX + (6-0{3) COMMONWEALTHOF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA17128~601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INmA[ Brown, Dorothy DATE OF DEATH (MM-DD-Year) 10/08/2003 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 1 7 5-0 3-2 6 5 9 Jane DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 04/29/1916 REGISTER OF WILLS IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INiTiAL} r~2. Supptemental Return r~4a. Futura Interest Compromise (dat~ ord~ae ar 12-12-82) E~7. Decedent Maintained a Living Trust (A~ch copy olTrust) ] 10, Spousal Pover[y Cradit (da~e of death bet,~.~e~ 12-31-91 and 1-1-95) NAME . Anthony Adams FIRM NAME (If Applicable) TELEPHONENUMBER 717-532-3270 Z 0 0 SOCIAL SECURITY NUMBER E~3. RemainderRetum (dateofdeathpdorto12-13-82} [~5. Federal Estate Tax Return Requirad __ 8. Total Number of Safe Depceit Boxes [] 11. Election to tax under Sec. 9113(A) (A~ch Sch OI COMPLETE MAILING ADDRESS 49 W. Orange Street Suite 3 Shippensbur,q PA 17257 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule S) (2) 3. Closely Held Corporation, Padnerahip or Sole-Proprietorship (3) 4. Mo~ages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Praper~ (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Prabata Pmperb/ (7) (Schedule G or L) 8, Total Gross Assets (tatal Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (1 O) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13. Chadtable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) OEFICIAI. USE ONLY 15~823.76 ~ (8) 15~823.76 2~742.85 (11) 2,742.85 (12) (13) 13~080.91 (14) 13~080.91 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15, Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 0.00 X __ (15) 16. AmountofLine14taxableatlinealrata 13,080.91 X ,045 (16) 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 (17) 18. Amount of Line 14 taxable at collateral rote 0.00 X .15 (18) 19. Tax Bue (19) 0.00 588.64 0.00 0.00 588.64 Decede, nt's Complete Address: STREET ADD,RESS 410 Big Spring Road CIT~ Newville I STATE PA IZIP 17241 Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pedr Payments C. Discount (1) Total Credits ( A + B + C ) (2) Interest/Penalty if applicable D, Interest E. Penalty Total Interest/Penalty ( D + E ) (3) If Line 2 is greater than Line I + Line 3, enter the difference, This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due, (SA) B, Enter the total of Line 5 + 5A This is the BALANCE DUE. {SB) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a trensfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ........................................ [] [] c. retain a reversionary interest; or ...................................................................................................... [] [] d. receive the premise for life of either payments, benefits or care? ............................................................. [] [] If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?. .............................................................................................. [] [] Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? ................. [] [] Did decedent own an Individual Retirement Account, annuity, or other non-prebate property which contains a beneficiary designation? ....................................................................................................... [] [] 588.64 0.00 0.00 0.00 588.64 588.64 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjur~, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and comptste, ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or ~er January 1, f 995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P,S, §9116 (a) (1.1) (ii)]. The statute dces not axemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July '1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(12) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P,S. §9116(a)(1,3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF BrQwnl Dorothy Jiane FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. and M&T Bank Account # Refund from Presbyterian Home Refund on Adams Electric Patronage 11,561.97 4,216.46 45.33 TOTAL (Also enter on line 5, Recapitulation) $ 15,823.76 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Brown, Dorothy Jane FILE NUMBER Debts of decedent must be reported on Schedule ], ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: Fogelsanger-Bricker Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Pemonal Representative (s) Social Security Nomber(syEIN Number of Pemonal Representative(s) Street Address City State Year(s) Commission Paid: ^t~omey Fees H. Anthony Adams Family Exemption: (If decedent's address is not the same as claiman['s, attach explanation) Claimant Zip Street Address city Relationship of Claimant to Decedent Probate Fees Accountanfs Fees Tax Return PrepareCs Fees Continuing Care RX Kirk W. Davis D.PM. State Zip 2,120.05 450.00 73.00 61.95 37.85 TOTAL (Also enter on line 9, Recapitulation) $ 2,742.85 (If more space is needed, insert add~onal sheets of the same size) REV-1513 EX + (9~n~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Brown Dorothv Jane RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE II. 1. TAXABLE DISTRIBUTIONS ~u.~?~ ~l~a h(t~s.~usaldistdbutions, andtmnsfemunder Jeanne L. Baker 20 Koser Lane Shippensburg, PA 17257 Richard L. Brown 414 Fredom Drive Shippensburg, PA 17257 Willliam D. Brown 30 Spring Drive Shippensburg, PA 17257 Lineal Lineal Lineal 4.5% 4.5% 4.5% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (if more space is needed, insert additional sheets of the same size) B~i~SAU O? INDIVTDUAL TAXES THHERTTAHCE TAX DXVISTON DEPT. Z80601 HARRISBURG, PA 17128-0601 CONMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT H ANTHONY ADAMS STE $ ~ q9 W ORANGE ST ,-. SHIPPENSBURG ~A1~7257 DATE ESTATE OF DATE OF DEATH FZLE NUHBER COUNTY ACN REV-1595 EX AFP (01-05) 10-15-200q BROWN DOROTHY J 10-08-2005 Z1 05-0865 CUMBERLAND 101 Amoun~ Rami~ed I HAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper cradi~ ~o your account:, submit: 'l:ha upper poFCion of ~his fore wi~h your ~cax payment. CUT ALONG THIS LINE ~,- RETATN LOWER PORTION FOR YOUR RECORDS ~ REV-1593 EX AFP (01-03) ~a INHERITANCE TAX RECORD ADJUSTMENT ESTATE OF BROWN DOROTHY J FILE NO. 21 03-0865 ACN 101 DATE 10-13-200~ ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION VALUE OF ESTATE: 1. Reel Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) ~. Closely Held S~ock/Par~cnership In~ares~ (Schedule C) q. Mor~cgegas/No~as Receivable (Schedule D) 5. Cash/Bank Daposi~cs/Misc. Personal Proper~y (Schedule E) 6. Join;cly Owned Proper~y (Schedule F) 7. Transfers (Schedule G) 8. To,al Asse~;s DEDUCTTONS AND EXEMPTIONS: 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule H) (9) 10. Deb~s/Mor~gage Liabill~cies/Liens (Schedule T) (iff 11. To*al Deductions 12. Ne~ Value of Tax Re~urn O0 (2) 00 ($) 00 (~) 00 (5) 15r823 76 (6) O0 (7) 00 (8) 15,823.76 2,7q2.85 .00 15. lq. TAX: 15. 16. Charitable/Governmental Bequests; Non-eZac~ed 9115 Trusts (Schedule J) Ne~ Value of Es~a~e Subjec~ ~o Tax Amoun~ of Line lfi a~ Spousal ra~e Amoun'l: of Line 1~* ~axabla a~ Lineal/Class A ra~e 17. Amoun'l: of L/ne lq a~ Sibling ra~a 18. Amoun~c of L/ne lq ~axeble a~ Colla~ceral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYFItM I Kb.t~,Y. lf' I UI~I;UUH I t + J DATE NUMBER INTEREST/PEN pAID (-) 03-12-Z00~ CD003679 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (15) (16) (17) (18) (l~) 2z7q2.85 (12) 13;080.91 (1:5) . O0 (lq) 13z 080.91 .OOX O0 = .00 13zO80.glx OqS= 588.6q .OOX 12 = .00 .OOX 15 = .00 (19) 588.6q .00 AMOUNT PAID 588.6q TOTAL TAX CREDIT I BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 588.6~ .00 .00 .00 ( IF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Make check or money order payable to: REGISTER OF NTLLS, AGENT. REFUND (CR): REPLY TO: A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's gq-hour answering service for forms ordering: 1-80O-$6Z-Z050) services for taxpayers with special hearing and / or speaking needs: 1-800-qq7-5020 (TT only3. guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individua! Taxes, ATTN: Post Assessment Reviee Unit, Dept. ZB060i, Harrisburg, PA I?iZB-060I, Phone (717) 787-6505. DISCOUNT: PENALTY: INTEREST: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SZ) discount of the tax paid is allowed. The 1SI tax amnesty non-participation penalty is computed an tha total of tha tax and interest assessed, and not paid before January 18, 1996) tha first day after the and of tha tax amnesty period. Interest is charged beginning with first day of delinquency or nine (9) months and one (1) day from the data of death to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rata of six ¢6Z3 percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which wil! vary from caIendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOq are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .OO0548 1988-1991 IZZ .00030! ZOO1 9Z .OOOZq7 1983 16Z .000q38 1992 9Z .0002q7 ZOOZ 6Z .00016q 1984 llZ .000301 1993-1994 7Z .O0019Z ZOO3 5Z .000137 1985 13Z .000356 1995-1998 9Z .000247 ZOOq qZ .000110 1986 IOZ .000274 1999 7Z .OO019E 1987 9Z .000247 ZOO0 8Z .OOOgl9 --Interest is calculatad as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINI;~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice) additional interest must be caXculated. ~EV-1470 ;SX (6-88) INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANOES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG~ PA 17128-0601 9ECEDENT'S NAME iFILE NUMBER DOROTHY J BROWN 2103-0865 ~EVIEWED BY ACN Phyllis Hoch 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES TAX RATE CHANGED ON ABOVE ACN, CHILDREN. ROW Pa.cle 1 Decedem: ~ CN:'6 ~\/'.. ~ ~ ~o we Date Death: ~~16=--o5-""~OQ~~~-- Estzte . ~.._Q~C'C2_ ~.=-- CD BJ~ S'w.___~w___ 'Is _" [alt,,~L~_.,._w Pursuant to Rule 6.12 the \\/1 th to the Court I the J, State~ether Df the estate is 2, that answer IS be 3 . If the ans\ver to 1 is state the account the a n ~ b, The Court (if the account c, thc p,""soru1 ""~n~e<::"nt"fiv" state an "1('''...'''1'1'''t ", ~'-y' ...... ."">< ~ ,_..~"",.. in 10 c. accoU.l1ts may be attache.d to this report Date: 9':./d2>J OS I .~~~~0~~ Signatnre \: ~' ~ ~CN"~ ~Q \JV'~ ~~t ' \J.J. 0 r~e-~"'<,".& ~.s.~~ (7Jc;7 J.LL5~"_=_.3~.,?O_ u"") ('j 0, t.f'~ ~ l._) .':.-') ,- c:~)- <:--J '\-~ Cumberland County - Register Of Wills One Courthouse Square ~arl~sle, PA 17013 Phone: (717) 240-6345 Date: 9/15/2005 ADAMS H ANTHONY 49 WEST ORANGE STREET SUITE 3 SHIPPENSBURG, PA 17257 RE: Estate of BROWN DOROTHY JANE File Number: 2003-00865 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/08/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~ GLENDA FARNER STRA~AUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/15/2005 ADAMS H ANTHONY 49 WEST ORANGE STREET SUITE 3 SHIPPENSBURG, PA 17257 RE: Estate of BROWN DOROTHY JANE File Number: 2003-00865 Dear Sir/Madam: It has come to my attention that you have not filed tHe Status Report by Personal Representative (Rule 6.12) in the above icaptioned estate. i As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT IRULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying qn or after July 1, 1992, the personal representative or his counsel, ~ithin two (2) years of the decedent's death, shall file with the Regilster of Wills a Status Report of completed or uncompleted administ~ation. I This filing is due by: 10/08/2005 Your prompt attention to this matter will be appreciat~d. I Thank You. Sincerely, I;; V d~ ~"~i_il ffk4L~~T GLENDA FARNER STR..Zl..S$AUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge L(d BS~EAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DE¢'T. 2806D1 HARRISBURG, PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX '04 ~CI' 15 F'2 :/7 H ANTHONY ADAHS STE $ 49 W ORANGE ST SHIPPENSBURG "~A~i7257 DATE 10-11-2004 ESTATE OF BROWN DATE OF DEATH 10-08-2005 FILE NUHBER 21 05-0865 COUNTY CUHBERLAND ACH 101 Amount ReeJ.~ed RE¥-1~47 EX AFP (01-05) DOROTHY J HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF BROWN DOROTHY J FILE NO. 21 03-0865 ACN 101 DATE 10-11-2004 TAX RETURN NAS: ( } ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEHENTAL RETURN 1. Real Estate (Schedule A} (1) 2. Stocks and Bonds [Schedule B) (2) 3. Closely Held Stock/Partnership Intsrest (Schedule C) (3) ~. Nortgagas/Notas Receivable (Schedule D} (~) 5. Cash/Bank Deposlts/Hisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule O) (7) 8. TotaZ Assets APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expensos/Adm. Costs/Hisc. Expenses (ScheduZo H) (9) 10. Dobts/Nortgago Liabilities/Lions (Schedule Z) (10) 11. Total Deduct ions 12. Net Value of Tax Return NO. 01 .00 NOTE: To insure proper . O0 credit to your account, · O0 submit the upper portion . O0 of this form with your · 00 tax payment. .00 .00 TAX CREDITS: PAYMENT DATE 03-12-200~ 13. 1~. NOTE: ASSESSHENT OF TAX: 15. Amoun~ of L/ne 1~ et Spousal rate (15) 16. Amount of L/ns 1~ taxable et Lineal/Class A rate (16) 17. Amount of Line lq at Sibling rate (17) 18. Aeount of Line 1~ taxable at Collateral/Class B rets (18) 19. Principal Tax Due RECEIPT NUHBER CD003679 D/$COUNT INTEREST/PEN PAID (-) .00 INTEREST IS CHARGED THROUGH 10-26-2004 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORH reflect figures that lnclude the total of ALL returns assessed to date. .00 x O0 = .00 .00 x 0~5= .00 13,080.91 x 12 = 1,569.70 .00 x 15 = .00 (19)= 1,569.70 ANOUNT PAID 588.64 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schaduls J) (13) Net Value of Estate Subject to Tax (lq) If an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 w111 588.64 981.06 11.87 992.95 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU NAY BE DUE~. A REFUND· SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) (8) .00 .00 .00 (11) . Off (12) . O0 .00 13,080.91 RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CA): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (coIlataraI) rate on any such future interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 91q0). Detach the top portion of this Notice and submit with your payment to the Ragistar of Hills printed an the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available mt the Office of the Register of Hills, any of the Z3 Revenue District OFfices, or by calling the special Iff-hour answering service for forms ordering: Z-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-$0Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-10Z1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booktet "Instructions for Inheritance Tax Return for a Resident Oecaden~' (REV-la01) for an explanation of administratively correctable errors. If any tax due is paid eithin three (3) calendar months after the dacedent's death, a five percent (5Z) discount of the tax paid is allowed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 200q ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ['~ ZOZ .O00Sq& ~'~-1991 X1Z .000~01 ~ 9Z .O00Zq7 1983 162 .000~38 1992 92 .O00Zq7 ZOOT 62 .00016q 198q X1Z .000301 1993-199q 7Z .00019Z 2003 52 .000137 1985 132 .000356 1995-1998 92 .0002~7 ZOO~ qZ .000110 1986 lOT .O00Z7q 1999 7Z .00019Z 1987 lOZ .O00Z7q ZOO0 7Z .O0019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (la) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. =~EV~1470 ~=X (6-88) INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME FILE NUMBER DOROTHY J. BROWN 2103-0865 ~EVIEVVED BY ACN CHARLES WRIGHT 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES Forwarded to Post Assessment Review Unit in reference to the reduction to the tax rate. ROW Page 1